Problems in the management and use of medical insurance funds: 1. The financial subsidy funds are not fully in place, mainly because the local finance does not fully budget the medical insurance expenses borne by the employee medical insurance unit, and some medical insurance funds are in arrears; Subsidy funds for enterprises with difficulties to participate in employee medical insurance are not fully in place. For example, from June 20 15 to June 20 16 in a county, the financial subsidy of 6,294.38 million yuan for employee medical insurance was not fully in place. 2. Some designated institutions and individuals defrauded the medical insurance fund. Individual designated medical institutions, especially private medical institutions, cheat medical insurance funds by hanging beds for hospitalization, reducing hospitalization indications, decomposing hospitalization, impersonating hospitalization, forging cases, etc. The funds in the personal account of medical insurance are withdrawn from individual designated medical institutions and retail pharmacies or used to buy daily necessities. 3, lax reimbursement audit caused the loss of medical insurance funds. The audit found that individual medical insurance managers had a weak sense of responsibility and made mistakes in understanding and applying policies, which led to out-of-range reimbursement and repeated reimbursement of medical expenses. 4, medical insurance agencies in arrears with designated institutions for more than half a year, increasing the burden of designated medical institutions.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.